Species distribution and clinical features of infection and colonisation with non-tuberculous mycobacteria in a tertiary care centre, central Germany, 2006–2016

Wetzstein, Nils; Hügel, Christian; Wichelhaus, Thomas A.; Hogardt, Michael; Eickmeier, Olaf; Küpper-Tetzel, Claus P.; Kann, Gerrit; Just‐Nübling, G.; Stephan, Christoph; Wolf, Timo

doi:10.1007/s15010-019-01317-2

Cited by 7 publications

(9 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The term NTMs includes all mycobacteria that do not belong to the Mycobacterium tuberculosis complex and M. leprae and encompasses more than 170 species with different capabilities of adaptation to specific environmental conditions and occurrence for each world region [1,5]. Humans have always been surrounded by these opportunistic pathogens, which may inhabit several ecological niches, such as soil, surfaces, water reservoirs, and food and animals, based on analysed species [6].…”

Section: Classification and Pathogenesismentioning

confidence: 99%

“…The transmission of NTMs occurs through exposure to contaminated aerosols, dust particles, or water, but the transmission from person to person has not been documented despite some genetic analysis on certain strains of M. abscessus in patients with cystic fibrosis revealing the possibility of this type of transmission via fomites and aerosols [1,7]. NTMs can affect any organ in the body, although the main clinical manifestations in adults are pulmonary disease (NTM-PD) and disseminated mycobacteriosis, while in children, local or generalized lymphadenitis is reported, though skin, soft tissue, pulmonary, central nervous system, and disseminated infections are also reported [6].…”

Section: Classification and Pathogenesismentioning

confidence: 99%

“…NTMs can be divided into slow-growing mycobacteria (SGMs) and rapid-growing mycobacteria (RGMs), as summarized in Table 1. The first group belongs to the Mycobacterium avium complex (MAC, which includes M. avium and M. intracellulare) and M. gordonae, which is the most important and widespread in the environment, while the second group belongs to the M. abscessus complex (MAbsC, differentiated into subspecies M. abscessus, M. massiliense, and M. bolletii), which is one of the most frequently isolated Mycobacterium species in patients with cystic fibrosis [1,6]. Among the variety of NTM species, differences in pathogenicity have been documented; M. gordonae or M. fortuitum, which are often found in the environment, have very low pathogenicity, while M. ulcerans and M. marinum are associated with disease in many cases.…”

Section: Classification and Pathogenesismentioning

confidence: 99%

See 2 more Smart Citations

Non-Tuberculous Mycobacterial Diseases in Children

et al. 2020

View full text Add to dashboard Cite

Non-tuberculous mycobacteria (NTMs) are ubiquitous and opportunistic emerging bacteria with the potential to colonize and eventually infect either immunocompromised or immunocompetent individuals. In the last three decades, the prevalence of disease caused by NTMs has increased in several countries. The increased prevalence of NTM infection can be explained by an ageing population with rising comorbidities, HIV infection, the common use of immunosuppressive drugs, and improved diagnostic methods. The aim of this review is to demonstrate the clinical relevance of NTMs in children, describing their features and manifestations, diagnostic tools, and therapeutic approaches. We collected data from the literature about NTM infections in young patients over the past five years (2014–2019) using the keywords “non-tuberculous”, “mycobacteria”, “paediatric”, “NTM”, “cystic fibrosis”, and “children”. Recent literature points out that NTMs are ubiquitous, with several species including both those that are pathogens for humans and those that are not. This means that, if a mycobacterium is isolated from a patient’s specimen, we have to distinguish between a simple colonization and an NTM-related disease. The start of treatment depends on many factors that are necessary to consider, such as clinical and imaging features, patient comorbidity and immunocompetence, drug adverse effects, and compliance with a very long therapy that can last many months. Due to the increasing prevalence and clinical relevance of NTMs, guidelines for their optimal management, especially in the presence of chronic underlying disease, are urgently needed.

show abstract

Section: Classification and Pathogenesismentioning

confidence: 99%

Section: Classification and Pathogenesismentioning

confidence: 99%

Section: Classification and Pathogenesismentioning

confidence: 99%

See 1 more Smart Citation

Non-Tuberculous Mycobacterial Diseases in Children

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In total, 98 MAC isolates from our previously published cohort for the period 2006-2016 were available for further processing. Patient data were retrieved from the local patient management system as previously described (Wetzstein et al, 2019). The patients were subgrouped into different clinical categories (NTM pulmonary disease or colonization -NTM-PD/C, disseminated mycobacteriosis, dermatological manifestations, lymphadenitis, and others), as well as into different underlying dispositions (CF, HIV, structural lung disease -SLD, malignoma, and others).…”

Section: Clinical Isolatesmentioning

confidence: 99%

Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complex

Wetzstein

Kohl

Andres

et al. 2020

International Journal of Infectious Diseases

Self Cite

View full text Add to dashboard Cite

Phenotypic (Sensititre Myco, pDST) and genotypic drug susceptibility testing (GenoType NTM DR, gDST) in M. avium complex (MAC) have become available as standardized assays, but comparable data is needed. This study aimed to investigate the phenotypic and genotypic drug susceptibility patterns in MAC clinical isolates. Methods: Overall, 98 isolates from 85 patients were included. pDST and gDST were performed on all isolates and results compared regarding specificity and sensitivity using pDST as a reference method. The impact of drug instability on pDST results was studied using a biological assay over 14 days. In addition, the evolution of antimicrobial resistance was investigated in sequential isolates of 13 patients. Results: Macrolide resistance was rare, 1.2% (95% CI 0.7-7.3) of isolates in the base cohort. No aminoglycoside resistances were found, but 14.1% of the studied isolates (95% CI 7.8-23.8) showed intermediate susceptibility. The GenoType NTM DR identified two out of four macrolide-resistant isolates. Antibiotic stability was demonstrated to be poor in rifampicin, rifabutin, and doxycycylin. Conclusions: pDST results in NTM for unstable antibiotics must be interpreted with care. A combination of pDST and gDST will be useful for the guidance of antimicrobial therapy in MAC-disease.

show abstract

“…Mainly, species of the M. avium complex (MAC, formerly called MAI-M. avium-intracellulare-complex) have been involved in disseminated infections in severely immunocompromised patients. Other NTM (as for example M. genavense), have also been described [1,6,7]. In disseminated disease, NTM can be cultured from different specimens such as citrate or EDTA blood, organ biopsies, sputum, bronchoalveolar lavage fluid and others.…”

Section: Introductionmentioning

confidence: 99%

Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction Disseminated infection due to non-tuberculous mycobacteria has been a major factor of mortality and comorbidity in HIV patients. Until 2018, U.S. American guidelines have recommended antimycobacterial prophylaxis in patients with low CD4 cell counts, a practice that has not been adopted in Europe. This study aimed at examining the impact of disseminated NTM disease on clinical outcome in German HIV patients with a severe immunodeficiency. Materials and methods In this retrospective case control study, HIV patients with disseminated NTM disease were identified by retrospective chart review and matched by their CD4 cell counts to HIV patients without NTM infection in a 1:1 alocation. Primary endpoints were mortality and time to first rehospitalisation. In addition, other opportunistic diseases, as well as antimycobacterial and antiretroviral treatments were examined. Results Between 2006 and 2016, we identified 37 HIV patients with disseminated NTM disease. Most of them were suffering from infections due to M. avium complex (n = 31, 77.5%). Time to event analysis showed a non-significant trend to higher mortality in patients with disseminated NTM disease (p = 0.24). Rehospitalisation took place significantly earlier in patients with disseminated NTM infections (median 40.5 days vs. 109 days, p<0.0001). Conclusion In this retrospective case control study, we could demonstrate that mortality is not significantly higher in HIV patients with disseminated NTM disease in the ART era, but that they require specialised medical attention in the first months following discharge.

show abstract

Species distribution and clinical features of infection and colonisation with non-tuberculous mycobacteria in a tertiary care centre, central Germany, 2006–2016

Cited by 7 publications

References 23 publications

Non-Tuberculous Mycobacterial Diseases in Children

Non-Tuberculous Mycobacterial Diseases in Children

Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complex

Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study

Contact Info

Product

Resources

About